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Corrective / Preventive Action Request

CAR Status:Open

Initiated By:Date:

(MM/DD/YY)

Part Description:

Part No:

NonConformance / Nonconformity Type:

Nonconformance:Major Internal Audit Finding:Supplier CAR (SCAR):x

External Audit Finding:

Customer Complaint:

Environmental Health and Safety:

Customer:

Reference:Process/ Department:

Brief Description (72 char. Max):DESCRIPTION

Quantity:2,000 pcs AQL size: 125 pcs

Repeat Occurrence (y/n):Assigned To:

Daniel Chen

Date Assigned:

2016/3/1Initial Resp. Due:worker

CONTAINMENT (immediate / interim / containment to prevent escape)

PO# 8508696 Inv# JY-16025 DMR#

Quality Control Area

Rev. B: five dimensions are out of specification

N/A

Daniela Solano Holder Blank

Joxco

Section 2: to be completed by person "Assigned To". Return to the Quality Department by the Response Due Date

Section 1: to be Completed by the Initiator

2016/2/24200072

Specification Actual

.558 / .556 .554 / .551.427 / .424.423

.375 both .360 / .359.177 / .174 .180

Corrective / Preventive Action Request CAR Status:Open

ROOT CAUSE ANALYSIS

Problem solving tools must be used to determine root cause and corrective action. Tools should be shown on or referenced and maintained as part of the record. Such tools include (but are not limited to): Brainstorming, affinity diagram (fishbone), 5-Why Method, Histogram, run chart, flow chart, check sheet, pareto chart, etc.

Section 3: Closure and Verification (to be completed by Quality or EHS personnel)

Have the documented actions been implemented and effective? Yes No

Evidence of Effectiveness:

Corrective / Preventive Action Request CAR Status:Open

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